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General NPI Number Information
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NPI Number | 1407991086
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Entity Type | Individual
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Provider Name | ROCKY HOLMES FNP
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Gender | Male
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 232 MARKET ST
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City | FLOWOOD
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State | MS
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Zip | 39232-3339
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Country | US
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Telephone | 337-991-9276
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Fax | 337-943-0846
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Provider Business Mailing Address
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Address Line | 3856 HWY 57 WEST PO BOX 99
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City | RAMER
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State | TN
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Zip | 38367
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Country | US
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Telephone | 731-645-6118
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Fax | 731-645-8312
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN8335
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R685993
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License Number State | MS
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